Revue médicale de Liège
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Synthesized as anesthetic agent about fifty years ago, ketamine (Ketalar) has been supplanted by more attractive anesthetic agents with less adverse effects. Nevertheless, the potential of this drug, although often unknown by many practitioners, remains significant. ⋯ Moreover, its efficacy to treat acute pain resistant to classic analgesics makes ketamine a very interesting and clinically-relevant drug for all practitioners facing this type of pain. This article reviews the clinical benefits of ketamine which has sometimes suffered from a negative reputation, but which possesses recently reconsidered wonderful pharmacological properties.
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Revue médicale de Liège · Jan 2010
[Extracorporeal membrane oxygenation (ECMO) in ICU patients suffering from cardiogenic shock, refractory hypoxemia or cardiac arrest].
ExtraCorporeal Membrane Oxygenation (ECMO) is a cardiopulmonary assistance device able to support patients in cardiac arrest, refractory cardiogenic shock or refractory hypoxemia otherwise sentenced to death. Recent technical progresses, early indication decision, bedside multidisciplinary implant, specific complications screening and echocardiographic weaning testing are crucial points to allow success of this exceptional technique.
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Revue médicale de Liège · Jan 2010
[Is a coagulation blood test compulsory before neuraxial blockade for labor analgesia?].
Neuraxial blockade such as epidural, spinal or combined spinal-epidural analgesia is considered to be the best technique for labour analgesia. Even if epidural hematoma is a very rare complication of neuraxial blockade, it may result in severe and definitive neurological injuries. This rare complication is usually associated with coagulation abnormalities. ⋯ This practice is questionable from the evidence-based medicine and the economic point of view. According to the guidelines published by several scientific societies, no routine coagulation screening tests are required in the absence of any history or clinical suspicion of coagulation impairment. The aim of the present article is to delineate the appropriate attitude in this context.